TRANSCRIBED GEN CAMATO

RBC STUDIES

HEMATOLOGY 1 | LECTURE

RBC series of maturation

1.
Rubriblast
n
also known as normoblast, pronormoblast
n
makes up 5 to 10% of the total nucleated red cell in bone
marrow
n
youngest form of RBCs
[
cytoplasm

deeply basophilic and relatively of small

amout
[
nucleus

relatively large, round or slightly oval with

1-2 nucleoli
[
nucleus to cytoplasm ratio

8:1
2.

Prorubricyte
n
also known as basophilic normoblast
[
cytoplasm

intensely basophilic and relatively small

amount
[
nucleus

relatively large, round and slightly oval

centrally located

if there's a presence of nucleoli they are

not visible
[
nucleus to cytoplasm ratio

6:1

3.

Rubricyte
n
also known as polychromatophilic normoblast
[
cytoplasm

gray-blue to pink in color

shows a wide range of colors because of

the start in hemoglobin formation
[
nucleus

still round, nucleoli in absent

[
nucleus to cytoplasm ratio

4:1

4.

Metarubricyte
n
also known as acidophilic normoblast, orthochromic
normoblast
n
fully hemoglobinated red cell that comprises 50% of the
total nucleated RBC in the bone marrow.
n
Last to contain nucleus
[
cytoplasm

pink to orange in color (similar to adult red

cell.
[
nucleus

having a pyknotic nucleus, relatively small

[
nucleus to cytoplasm ratio

1:2

5.

Reticulocyte
n
also known as retics, polychromatophilic erythrocyte
n
you will observed basophilic fine reticulum of RNA in the
cytoplasm
n
this is demonstrated by the supravital stain.
[
nucleus

none
[
cytoplasm

pink to reddish brown

fibro

Wright stain most commonly used stain in Hematology

Methylene alcohol as FIXATIVE; w/o will washed

away

Methylene blue used to stain NUCLEUS (acidic)

Eosin

Phosphate Buffer saline

Supravital stain stains the living cells

New Methylene Blue

Brilliant Cresyl Blue

6.

Requirements for the maturation of RBC

1.
There must be adequate amount of hematopoeitic factor
2.
There must be an adequate supply of Fe in usuable form.
3.
There must be an adequate amount of protoporphyrin(Protoporphyrin 9)
4.
There must be an adequate supply of globin (Protein)
Statistical factor that could affect the RBC count
1)
Posture
r
there is a decrease around 5.7% of hemoglobin and
hematocrit level in the recumbent position.
2)
Exercise/emotion/excited
r
may increase the RBC count.
3)
Dehydration
r
may also attribute to increase the RBC count
4)
Age
r
the younger the patient the higher the value of hemoglobin,
hematocrit
5)
Gender
r
Male: may increase RBC count
6)
Altitude
r
High altitude

decrease of oxygen, the BM will produce more

Rbc to compensate the decrease of oxygen.
1

Erythrocyte
n
Aka mature RBC
[
size

8.2 m (or cubic micra)

[
thickness

biconcave disc shape (0.8-2.8u3)

[
life span

120 days

*transfused RBCs 120days lifespan

[
for every 100 rbc there is approximately 3-8
platelets found
[
for every 1000 rbc there is one WBC
[
Normal Value
Million
3

Female: 4.5 5.5

/ mm
Million
3

Male: 5.5 6.5

/ mm

increase level of testosterone (MALE)

Objectives used:

HPO WBC; factor 2,000

OIO Platelets; 20, 0000

Hirisutism excessive hairs (FEMALE)

[
Cytoplasm

biconcave disc shape with orange to pink

color that is pale staining at the venter
that occupies 1/3 of cell size of rbc area.
[
RBC is compose of protein lipid stroma that
contains Hb in solution and condense in lipid rich
peripheral cell membrane.

> Hypochromia

< Hyperchromia

Normal Value:

0.5 1.5% found in circulation

98.5 99.5% found in bone

marrow

TRANSCRIBED GEN CAMATO

RBC STUDIES

HEMATOLOGY 1 | LECTURE

RBC anomalies
I.

d)

Anisocytosis variation in size

a)
Normocyte

normal RBC size: 6.2-8.2 um

b)
Microcyte

less than 6.2um small rbc

c)
Macrocyte

large RBC, greater than 9um

d)
Megalocyte

giant rbc seen in megalocytic anemia due to

deficiency of vitamin B12 (cyanocobalamin) or
folic acid.

Size: from 12-21um

e)
II.

Elliptocytes

Elliptical shape of rbc (also called ovalocytes)

Found in Pernicious Anemia
9 Hypersegmented neutrophil
* > 5 lobules

Blister cell

Poikilocytosis variation shape of RBC

a)
Acanthocytes

Also known as Thorn cell, spur cell

Round rbc with around 5-10 irreversible thorn like
projection

Indicative of permanent cell damage

Found in patient with abetalipoproteinemia

Abetalipoproteinemia

absence of Low Density Lipoprotein;

if NO LDL will cause permanent cell damage because

LDL is responsible for the distribution of cholesterol
b)

f)

Helmet cell

Burr cell

c)

RBC with thin peripheral cell membrane.

Found in microangiopathic hemolytic anemia

RBC with reversible thorn-like projection and

is some what elongated.

g)

(triangle cell, keratocyte of bessis /

contracted RBC)
Results after the blistered or ruptured blister cell
that would become a helmet/triangle cell.

Sickle cell

Crenated RBC

Also known as echinocyte

RBC with short blunt spicules found all over the
cell.

Finely serrated RBC

No clinical significance, this condition only occurs

in RBC that has been placed under
hypertonic NaCl solution I > 0.9 %
Normal Saline Solution (0.85 0.9% NaCl solution)

(drepanocyte, meniscocyte)
C shape, crescent shape, sickled RBC
Occurs in the presence of Hb S and found in
sickle cell anemia
Refers also as resistant cell, irreversible reaction

TRANSCRIBED GEN CAMATO

RBC STUDIES

h)

Spherocyte

i)

HEMATOLOGY 1 | LECTURE

m)

Small, round, darkly staining rbc found in

hereditary spherocytosis and some hemolytic
anemia.
Fragile cell
Erythrocyte Osmotic Fragility Test (EOFT)
Useful in identifying fragile cell and resistant
cell
If spherocyte or sickle cell identification.
Use different concentration of hypotonic NaCl
solution. (0.5 % NaCl 50-85)

n)

o)

j)

Fragmenting or disintegrating RBC found in

hemolytic anemia, patient with severe burns and
who suffers in DIC (Diffuse Intravascular
Coagulation syndrome)

III.

k)

l)

Mouth cell
RBC with mouth-like clear central area found in
hereditary stomatocytosis, alcoholism and liver
diseases.

Stellar cell

(Astrocyte)
Star-like RBC found in some anemias

Tear drop RBC

Target cell

Dacrocytes, pear-shaped
Found in thalassemia

RBC with peripheral and central condensation of

Hb. With clear zone in between.
Found in thalassemia.

Anisochromasia variation in color of RBC

a)
Normochromic/ normochromasia

Normal hb content of RBC

b)
Hypochromic/ hypochromasia

Decrease of hb content and normally RBCs are

with pale central area
c)
Hyperchromic/ hyperchromasia

Increase hb content due to a thick cell wall.

d)
Polychromic/ polychromasia

RBC with uneven distribution of Hb so the RBC

stains unevenly
e)
Anulocyte

(pessary cells, ghost cell)

RBC with thin rim of hb with clear central area

seen in Fe deficiency anemia
9
Lacks Intrinsic Factor (IF)
9
Absorption site of Fe Duodenum
9
Absorption site of Folate Jejunum
9
Absorption site of Vitamin B12 Ileum
f)

Irregular contracted distorted rbc

Found among infants less that 3 months old.

Target cell

Stomatocyte

Similar to tear drop except that it has a longer tail

forming like a racket handle

Pyknotic cell (pyknocyte)

Schistocyte

Racket cell

May categorized as poikilocytosis

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and in purity.
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3